Results

Technical success was achieved in 98.2% (320/326) of subjects. Primary effectiveness (complete thrombosis at 24 h) was achieved in 74.5% (108/145). Twenty-five subjects underwent repeat thrombin injection, successful in 21 subjects, for a total effectiveness rate of 97.0% (129/133). No imaging factor was associated with technique failure, including number of lobes (p = 0.898), largest dimension (p = 0.344), or volume (p = 0.697). No statistically significant difference in pre-procedure INR, aPTT, or platelet count was found between subjects with CT and those with IT (p > 0.138). Anticoagulation therapy was associated with incomplete thrombosis (35.5% [38/107] for CT vs. 63.9% [23/26] for IT; p = 0.002).

Conclusion

Imaging-guided percutaneous thrombin injection has high technical success and effectiveness rates for the treatment of iatrogenic femoral artery PSA. Anticoagulation therapy was the only factor associated with incomplete thrombosis.

Keywords

This work was presented as an oral abstract at the Radiological Society of North America Annual Meeting on December 1, 2017. Use of thrombin is an “off-label” but standard treatment to achieve thrombosis of extremity pseudoaneurysms.

IRB statement

This retrospective study was approved by our institutional review board and was compliant with the Health Insurance Portability and Accountability Act. The requirement for written informed consent was waived.

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Esterson YB, Pellerito JS (2017) Recurrence of Thrombin-Injected Pseudoaneurysms Under Ultrasound Guidance: A 10-Year Retrospective Analysis. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 36:1617-1624CrossRefGoogle Scholar